A 2-cycle prospective audit of the prevalence of methicillin-resistant Staphylococcus aureus in adult rhinology patients

Debashis Dass¹, Artemis Christoforidou², Hisham S Khalil², Adrian Lee^2
1Peninsula College of Medicine and Dentistry, Derriford Hospital, Plymouth, England, UK; ²Department of Otolaryngology, Derriford Hospital, Plymouth, England, UK

Purpose: To audit the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carrier state in rhinology patients, secondary aims included looking at the compliance of a newly introduced hospital MRSA screening and eradication protocol.
Patients and methods: The first cycle included 113 rhinology patients and 62 otology patients. The second cycle included 123 consecutive rhinology patients attending the pre-assessment clinic (PAC).
Results: No rhinology patients in the first cycle appeared to be colonized with MRSA one otology patient was colonized with MRSA. The second cycle found that four rhinology patients (3.25%) should have been treated as colonized with MRSA according to protocol. Of these, two were newly colonized and two had a previous history of MRSA colonization. Only one of the latter was found to be positive. Three patients had eradication treatment. Re-swabbing was performed in three of the four patients and confirmed eradication of MRSA. The protocol was followed completely in one patient only.
Conclusion: The prevalence of MRSA appears to have increased over a two-year period. This may be due to increasing community-acquired MRSA. The overall prevalence is still low when compared to other specialties. MRSA does not appear to cause significant morbidity or mortality in rhinology patients. Protocol may need to be simplified if implementation is to be improved.

Keywords: audit, mupirocin, triclosan, otolaryngology, nasal, infection